Ankle Fractures: Overview

Ankle Fractures: Overview

An ankle fracture, known as a broken ankle, means that one or more of the bones that make up the ankle joint has a break in it. Ankle fractures can range from simple, one break in one bone, to very complex, with multiple bony fragments and involvement with more than one bone of the ankle joint. Approximately 2% of the population will sustain an ankle fracture during their lifetime.

Ankle fractures represent 9% of all fractures that present in the emergency room, with 25% of those requiring surgery. Females have a higher risk, especially as they age, to sustain an ankle fracture compared to males. Other risk factors include higher body mass index and diabetes. Ankle fractures result from a twisting injury to the ankle joint. Many ankle fractures result from simply falling while walking.

Other causes of ankle fractures include motor vehicle accidents, a fall from heights, tripping down the stairs, or sports-related injuries. Ankle fractures can happen to anyone, but there are some steps you can take to reduce your risk. There are certain medical conditions that make our bones more susceptible to fracture, such as diabetes. Therefore, maintaining a healthy lifestyle, including a well-balanced diet, are recommended.

In addition to managing your overall health, clearing areas for any tripping hazards at work or home, in addition to wearing comfortable and stable footwear can also help reduce your risk. Now, let us take a closer look at the anatomy. The ankle joint is comprised of 3 bones: the small bone that sits outside of the ankle, called the fibula; the shinbone, known as the tibia; and a bone that sits above the heel bone and below the shinbone, known as the talus.

Ankle fractures most commonly occur at the bottom aspect of the outside ankle bone, the fibula. Some fractures may have a break at the bottom of the shinbone in conjunction with the break in the fibula. A fracture may also occur at the bottom of the shinbone in isolation, although this is not as common. In addition to the bones of the ankle, another common injury seen in ankle fractures occurs to the syndesmosis.

The syndesmosis is where the shinbone, the tibia, and the smaller bone next to it, the fibula, connect via multiple ligaments. This joint plays an important role in the stability of the ankle joint. These ligaments can tear, in addition to the ankle breaking, and can result in what is called an unstable ankle. Those who have suffered an ankle fracture often complain of pain, bruising, and swelling. There may be a noticeable deformity to the ankle joint, and they may be unable to bear weight on the injured leg.

When seeking treatment with a health care provider, they will ask questions about how the injury occurred, if there was any prior evaluation, and details about your medical history. Afterwards, a physical examination will be performed on the lower leg. The surgeon will look at the ankle for signs of bruising and swelling. In addition, they will feel the ankle, particularly around the bony prominence on the inside of the foot called the medial malleolus, and outside of the foot, the lateral malleolus.

The diagnosis of an ankle fracture is confirmed using x-ray studies. The surgeon will order different views of the ankle, which helps determine the location and pattern of the fracture itself. A CT scan may also be ordered in more complex fractures for further evaluation of the bony anatomy and can help the surgeon plan for surgery. When an ankle fracture has been diagnosed, the surgeon will take many factors into consideration when considering nonsurgical and surgical treatment and share this with the patient so they are ready for what comes next.